5 myths about prostate cancer
Prostate cancer, the leading cancer affecting men in Jamaica, is quite a topical subject. Efforts of the Jamaica Urological Society, which incidentally celebrates 20 years of existence this year, have aimed at increasing public knowledge about the disease. This is done in partnership with the Jamaica Cancer Society through public educational fora, voluntary screening clinics and talks at public and private organisations.
I have always found some of the questions posed at public talks interesting. They have led me to believe that there are several myths surrounding prostate cancer.
The following perhaps represents the top five myths surrounding prostate cancer.
1. Prostate cancer only affects old men
Prostate cancer is a disease of ageing men and the prevalence increases as men get older. However, prostate cancer may be seen in men less than 50 years of age. In fact, hereditary prostate cancer is diagnosed if a man has two first-degree family members diagnosed with the disease before age 55 years. A few cases of prostate cancer have been diagnosed locally in men in their late 30s with a family history of the disease.
2. Increased sexual activity reduces the risk of prostate cancer
Lietzmann et al in 2004 published in JAMA on the association of ejaculation frequency and risk of prostate cancer. Ejaculation frequency was assessed with sexual intercourse or masturbation. The study did not find an association between ejaculation frequency and risk of prostate cancer. So, men, more sex neither lessens nor increases your risk of prostate cancer!
3. Ackee consumption is the cause of the high rate of prostate cancer in Jamaica
There is an association between dietary fatty acids and prostate cancer risk. Ackee, which contains fatty acids, is often blamed for the high rate of prostate cancer in Jamaica. This has, however, not been proven. No retrospective or prospective dietary study has been done in our population to evaluate this proposed risk. I am not aware that Jamaican men have a higher consumption of fat than men elsewhere.
4. Early prostate cancer will present with difficulty urinating
Men with early prostate cancer have no symptoms. The diagnosis in these men is only established after doing their screening tests, usually, with a finding of an elevated PSA. We do not
recommend that men wait until they have urinary symptoms before screening. This approach will usually lead to a diagnosis of prostate cancer at a more advanced stage. Some men with early prostate cancer may, in fact, have urinary symptoms that are not due to cancer but rather the "benign" or "non- cancerous" enlargement of the prostate that occurs with increasing age.
5. Prostate cancer treatment leads to 'impotence'
A diagnosis of prostate cancer may be so overwhelming that "psychogenic erectile dysfunction" occurs. However, this may be overcome with counseling and support from prostate cancer survivors. Organic erectile dysfunction is a potential risk with treatment of prostate cancer. The risk is highest in men who already have erectile dysfunction or those over the age of 60 years. However, many men do not have erectile dysfunction with treatment. Effective therapeutic options are available locally for those men who develop erectile dysfunction.
We encourage men to initiate screening for prostate cancer. Visit your family doctor or urologist and have your PSA and DRE done.